Endocrinology, Diabetes and Metabolism最新文献_第5页

Once-Weekly Insulin Efsitora Alfa Versus Once Daily Insulin in Patients With Type 2 Diabetes: A Systematic Review and Meta-Analysis 2型糖尿病患者每周一次胰岛素Efsitora与每天一次胰岛素：系统回顾和荟萃分析

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-28 DOI: 10.1002/edm2.70126

Harris Mehmood, Moaz Alowami, Thel Su Hlaing, Khant Nyi Zaya, Yousrah Uraiby, Ahmed Muaaz Alam, Abubakr Adala, Osama Ikram, Syed Faisal Ali, Muzammil Farhan, Eeshal Zulfiqar, Mushood Ahmed, Raheel Ahmed, Ammara Naeem

Background

Once-daily basal insulin is widely used in the management of type 2 diabetes, but poor adherence to daily injections often impairs glycaemic control. Once-weekly efsitora alfa may overcome these limitations, but pooled data assessing its comparative efficacy and safety remain limited.

Methods

PubMed/MEDLINE, Google Scholar, and the Cochrane Library were searched up to July 2025 for RCTs comparing once-weekly efsitora with once daily insulin in adults with T2D. Weighted mean differences (MDs), odds ratios (ORs), and risk ratios (RRs) were pooled using a random-effects model, and results were reported with 95% confidence intervals.

Results

Six RCTs comprising 3967 participants were included. There were no significant differences between once-weekly efsitora and daily insulin in change in HbA1c (MD –0.04; 95% CI –0.10 to 0.02; p = 0.15), change in fasting plasma glucose (MD 1.94 mg/dL; 95% CI –2.98 to 6.86; p = 0.44), proportion of patients achieving HbA1c < 7%, change in body weight, or time below range. Efsitora was associated with an increase in time in range (MD 0.80 percentage points; 95% CI 0.09 to 1.52; p = 0.03) and a reduction in time above range (MD –1.45 percentage points; 95% CI –2.87 to −0.02; p = 0.05). The risk of treatment-emergent adverse events (TEAEs) was higher with efsitora (RR 1.13; 95% CI 1.05 to 1.20; p = 0.0004), whereas serious adverse events, hypersensitivity reactions, injection-site reactions, and hypoglycaemia events were comparable between the two groups.

Conclusion

Once-weekly efsitora provides comparable glycaemic control and improved time-in-range compared to daily insulin, although with a higher rate of TEAEs.

背景：每日一次的基础胰岛素被广泛应用于2型糖尿病的治疗，但每日注射的依从性差往往会损害血糖控制。每周一次的efsitora可以克服这些限制，但评估其相对疗效和安全性的汇总数据仍然有限。方法：检索PubMed/MEDLINE、谷歌Scholar和Cochrane Library截至2025年7月的rct，比较每周一次的胰岛素注射与每天一次的胰岛素注射对成年T2D患者的影响。加权平均差异（MDs）、优势比（ORs）和风险比（rr）采用随机效应模型合并，结果以95%置信区间报告。结果：纳入6项随机对照试验，共3967名受试者。在HbA1c变化（MD为-0.04；95% CI为-0.10 ~ 0.02;p = 0.15）、空腹血糖变化（MD为1.94 mg/dL； 95% CI为-2.98 ~ 6.86;p = 0.44）、达到HbA1c的患者比例方面，每周一次efsitora和每日胰岛素治疗之间无显著差异。结论：与每日胰岛素治疗相比，每周一次efsitora提供了相当的血糖控制和改善的时间范围，尽管teae发生率更高。

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引用次数: 0

Efficacy and Safety of iLet Bionic Pancreas in Patients With Type 1 Diabetes Mellitus: A Systematic Review and Meta Analysis iLet仿生胰腺治疗1型糖尿病的疗效和安全性：系统评价和Meta分析

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-28 DOI: 10.1002/edm2.70127

Sunny Kumar, F. N. U. Aakash, Nisha Kumari, Chandar Kanta Lohana, Alina Abbas, F. N. U. Gyaneshwari, Raveena Kumari, F. N. U. Eman, Reena Bai, Saifullah Syed, Mahveer Maheshwari, Rahul Rai, Faiqa Iqbal, Mohammad Jawwad, Hira Riaz

Background

This systematic review and meta-analysis evaluated the efficacy and safety of the iLet bionic pancreas (iLet BP), a novel automated insulin delivery (AID) system, in managing type 1 diabetes. Unlike conventional AID systems, which require user input for insulin dosing, the iLet BP autonomously determines insulin delivery based solely on body weight. The study synthesized data from five randomized controlled trials (RCTs), comprising a total of 1130 patients, comparing iLet BP with standard care (SC).

Outcomes Assessed

Primary outcomes included changes in HbA1c, mean glucose levels, and time in target glucose range (70–180 mg/dL), measured via continuous glucose monitoring (CGM). Secondary outcomes assessed adverse events and hypoglycaemia.

Key Findings

Results demonstrated that the iLet BP significantly improved glycaemic control. The pooled analysis showed a standardised mean difference (SMD) in HbA1c of −0.50 [−0.63, −0.38] and in mean glucose levels of −0.36 [−0.50, −0.21] favouring iLet BP. Time in target glucose range was significantly higher with iLet BP (SMD: 0.58 [0.43, 0.73]). However, the odds of adverse events were notably higher in the iLet BP group (OR: 15.48 [8.07, 29.70]), while the risk of hypoglycaemia (OR: 2.22 [0.83, 5.94]) was not statistically significant.

Conclusion

In conclusion, the iLet BP shows strong potential in improving glycaemic outcomes in patients with type 1 diabetes. However, concerns remain regarding its safety profile, particularly related to adverse events. Further large-scale, high-quality studies are needed to confirm its effectiveness and ensure broader clinical applicability.

背景：本系统综述和荟萃分析评估了iLet仿生胰腺（iLet BP）治疗1型糖尿病的有效性和安全性，iLet BP是一种新型的自动胰岛素输送（AID）系统。与需要用户输入胰岛素剂量的传统AID系统不同，iLet BP仅根据体重自主决定胰岛素的剂量。该研究综合了5项随机对照试验（RCTs）的数据，共包括1130名患者，比较了iLet BP和标准治疗（SC）。评估的结局：主要结局包括HbA1c、平均血糖水平的变化，以及通过连续血糖监测（CGM）测量的目标血糖范围（70-180 mg/dL）的时间。次要结局评估不良事件和低血糖。主要发现：结果表明，iLet BP显著改善血糖控制。合并分析显示，HbA1c的标准化平均差异（SMD）为-0.50[-0.63,-0.38]，平均葡萄糖水平为-0.36[-0.50,-0.21]，有利于iLet BP。在目标血糖范围内停留的时间明显高于iLet BP （SMD: 0.58[0.43, 0.73]）。然而，iLet BP组不良事件发生的几率明显更高（OR: 15.48[8.07, 29.70]），而低血糖发生的风险（OR: 2.22[0.83, 5.94]）无统计学意义。结论：总之，iLet BP在改善1型糖尿病患者的血糖结局方面显示出强大的潜力。然而，对其安全性的担忧仍然存在，特别是与不良事件有关。需要进一步大规模、高质量的研究来证实其有效性并确保更广泛的临床适用性。

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引用次数: 0

The Effect of Yacon Consumption on Glycemic Control and Lipid Profiles: A Systematic Review and Meta-Analysis of Randomised Controlled Trials 食用雪莲果对血糖控制和血脂的影响：随机对照试验的系统回顾和荟萃分析。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-28 DOI: 10.1002/edm2.70121

Maryam Nilghaz, Fatemeh Sheikhhossein, Mahnoush Mehrzad Samarin, Mohammad Reza Amini, Mahsa Elahikhah, Moharam Jalalzadeh, Maryam Khakbaz, Negin Lohrasbi, Sajjad Etesamnia, Fatemeh Torkizadeh, Azita Hekmatdoost

Background

Recent human studies have indicated the beneficial effects of yacon on diabetes and metabolic syndrome; however, no meta-analysis has investigated the effects of yacon on glycemic control and lipid profiles.

Methods

Searches were conducted in five databases—PubMed, Web of Science, Scopus, Google Scholar, Cochrane Library—and relevant randomised controlled trials (RCTs) until June 2024. The random-effects model was employed to compute the effect size, thereafter represented as a weighted mean difference (WMD) and a 95% confidence interval (CI). This study's registration number in PROSPERO is CRD420251028504.

Results

This study integrated seven RCTs with 239 participants. The results demonstrated that yacon consumption had no statistically significant effects on fasting blood sugar (FBS, p = 0.33), insulin levels (p = 0.76), homeostasis model assessment for insulin resistance (HOMA-IR, p = 0.42), total cholesterol (TC, p = 0.17), low-density lipoprotein (LDL, p = 0.12), high-density lipoprotein (HDL, p = 0.42), or triglycerides (TG, p = 0.75). However, subgroup studies indicated that yacon consumption reduced FBS levels over an exceeding 8-week duration in both sexes and in persons over 40. Furthermore, yacon intake resulted in a decrease in LDL-cholesterol levels for more than 8 weeks, particularly in women and individuals over 40. Additionally, it led to a decrease in LDL-cholesterol levels among women and individuals over 40 who consumed yacon for more than 8 weeks, and HDL-cholesterol levels increased in those aged 40 and above.

Conclusion

Overall, this meta-analysis indicates that yacon use in adults does not lead to significant improvements in lipid profiles or glycemic parameters.

背景：最近的人体研究表明，雪莲果对糖尿病和代谢综合征有有益的作用；然而，没有荟萃分析调查雪莲果对血糖控制和血脂的影响。方法：截至2024年6月，在pubmed、Web of Science、Scopus、b谷歌Scholar、Cochrane library等5个数据库和相关随机对照试验（RCTs）中进行检索。采用随机效应模型计算效应大小，然后用加权平均差（WMD）和95%置信区间（CI）表示。本研究在PROSPERO的注册号为CRD420251028504。结果：本研究纳入7项随机对照试验，239名受试者。结果表明，食用雪雪果对空腹血糖（FBS, p = 0.33）、胰岛素水平（p = 0.76）、胰岛素抵抗稳态模型评估（HOMA-IR, p = 0.42）、总胆固醇（TC, p = 0.17）、低密度脂蛋白（LDL, p = 0.12）、高密度脂蛋白（HDL, p = 0.42）或甘油三酯（TG, p = 0.75）均无统计学意义。然而，亚组研究表明，在超过8周的时间内，无论是男女还是40岁以上的人，食用雪茄烟都会降低FBS水平。此外，食用雪糕可使低密度脂蛋白胆固醇水平下降超过8周，尤其是女性和40岁以上的人。此外，食用雪莲果8周以上的女性和40岁以上的人的低密度脂蛋白胆固醇水平下降，而40岁及以上的人的高密度脂蛋白胆固醇水平上升。结论：总的来说，这项荟萃分析表明，成人使用雪莲果不会导致血脂或血糖参数的显着改善。

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引用次数: 0

The Effect of Kefir Consumption on Blood Pressure and C-Reactive Protein: A Systematic Review and Meta-Analysis of Randomised Controlled Trials 饮用开菲尔对血压和c反应蛋白的影响：随机对照试验的系统回顾和荟萃分析。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-26 DOI: 10.1002/edm2.70124

Elaheh Rashidbeygi, Mahnoush Mehrzad Samarin, Fatemeh Sheikhhossein, Amir Hossein Khalilkhaneh, Masoomeh Gholizadeh, Negin Lohrasbi, Amin Abbasi, Hadi Bazyar, Gholamreza Askari, Mohammad Reza Amini

Background

Kefir, a traditional fermented milk beverage, has been increasingly promoted for its various health benefits. This systematic review and meta-analysis of randomised controlled trials (RCTs) aimed to assess the effects of kefir on blood pressure and C-reactive protein (CRP) levels.

Methods

A literature search was conducted using databases such as ISI Web of Science, Scopus and PubMed for articles published until January 2025, with no restrictions. A random-effects meta-analysis was conducted for all key outcome measures. The inverse-variance weighted mean difference (WMD) was calculated with a 95% confidence interval (CI).

Results

A total of seven RCTs, comprising 385 subjects, were included in the meta-analysis. We involved RCTs conducted on adult participants (over 18 years old). These studies generally administered kefir for at least 2 weeks and compared the outcomes to those in the control group. The findings showed that kefir consumption had no significant impact on systolic blood pressure (SBP) (WMD: −1.76 mmHg; 95% CI: −5.21, 1.69; p = 0.317), diastolic blood pressure (DBP) (WMD: −1.19 mmHg; 95% CI: −3.40, 1.03; p = 0.295) or CRP levels (WMD: −0.17 mg/L; 95% CI: −0.84, 0.49; p = 0.609) compared to those who did not consume kefir. However, subgroup analysis indicated that CRP levels significantly decreased with longer durations of kefir consumption (≥ 8 weeks).

Conclusion

Kefir consumption in adults did not result in significant reductions in systolic or diastolic blood pressure or CRP levels. Nonetheless, there is some evidence that long-term kefir consumption may improve CRP levels over time.

背景：开菲尔是一种传统的发酵乳饮料，因其多种健康益处而受到越来越多的推广。本系统综述和荟萃分析的随机对照试验（rct）旨在评估开菲尔对血压和c反应蛋白（CRP）水平的影响。方法：使用ISI Web of Science、Scopus、PubMed等数据库检索2025年1月前发表的无限制文章。对所有关键结局指标进行随机效应荟萃分析。以95%置信区间（CI）计算反方差加权平均差（WMD）。结果：meta分析共纳入7项rct，共385名受试者。我们纳入了对成年参与者（18岁以上）进行的随机对照试验。这些研究通常给予开非尔至少2周，并将结果与对照组的结果进行比较。研究结果显示，与不喝开非尔的人相比，喝开非尔对收缩压（SBP）（WMD: -1.76 mmHg; 95% CI: -5.21, 1.69; p = 0.317）、舒张压（DBP）（WMD: -1.19 mmHg; 95% CI: -3.40, 1.03; p = 0.295）或CRP水平（WMD: -0.17 mg/L; 95% CI: -0.84, 0.49; p = 0.609）没有显著影响。然而，亚组分析表明，CRP水平随着开菲尔饮用时间的延长（≥8周）而显著降低。结论：成人饮用开非尔不会显著降低收缩压或舒张压或CRP水平。尽管如此，有证据表明长期饮用开菲尔可能会随着时间的推移提高CRP水平。

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引用次数: 0

Vitamin D for Painful Diabetic Neuropathy: A Systematic Review and Meta-Analysis of Randomised Controlled Trials 维生素D治疗疼痛性糖尿病神经病变：随机对照试验的系统回顾和荟萃分析。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-26 DOI: 10.1002/edm2.70118

Abraham Gilbody, Joseph Gilbody

Background

Painful diabetic neuropathy (PDN) is a common complication of type 1 and type 2 diabetes, causing substantial morbidity. Current treatments, including antidepressants and analgesics, are often only partially effective and may have significant side effects. Vitamin D deficiency affects around 60% of people with diabetes, making supplementation a low-toxicity, biologically plausible intervention. Observational studies suggest potential benefit, but robust evidence from randomised controlled trials (RCTs) is lacking.

Objective

To systematically review and synthesise RCT evidence on the effect of vitamin D supplementation on pain outcomes in PDN.

Methods

A systematic search was conducted in Medline, EMBASE, Web of Science, Cochrane Library, CINAHL, EBSCO and Google Scholar up to September 2025. Eligible studies were RCTs comparing vitamin D supplementation with placebo in adults with diabetes and PDN. The primary outcome was pain intensity measured with validated tools. A fixed-effects meta-analysis was performed, with results expressed as standardised mean differences (SMD). Risk of bias was assessed using the Cochrane RoB tool, and publication bias examined via Egger's funnel plot.

Results

Five studies met inclusion criteria; four (n = 320) were included in the meta-analysis. Pooled results showed a significant short-term reduction in pain with vitamin D versus placebo (SMD = −0.85; 95% CI: −1.07 to −0.62), with moderate heterogeneity (I² = 61.4%), equivalent to ~11 points on common pain scales. No studies reported medium- or long-term outcomes. Study quality varied, with concerns regarding allocation concealment and selective outcome reporting. Four trials were prospectively registered.

Conclusion

Vitamin D supplementation may reduce short-term pain in PDN, but evidence is limited by small sample sizes and methodological quality. Larger, rigorously designed RCTs with longer follow-up are needed before routine vitamin D testing or supplementation can be recommended for PDN in clinical practice.

背景：疼痛性糖尿病神经病变（PDN）是1型和2型糖尿病的常见并发症，发病率很高。目前的治疗方法，包括抗抑郁药和止痛药，往往只是部分有效，可能有明显的副作用。大约60%的糖尿病患者缺乏维生素D，因此补充维生素D是一种低毒性、生物学上合理的干预措施。观察性研究提示潜在的益处，但缺乏来自随机对照试验（RCTs）的有力证据。目的：系统回顾和综合维生素D补充对PDN患者疼痛结局影响的RCT证据。方法：系统检索Medline、EMBASE、Web of Science、Cochrane Library、CINAHL、EBSCO、谷歌Scholar等数据库，检索截止日期为2025年9月。符合条件的研究是比较维生素D补充剂与安慰剂在糖尿病和PDN成人患者中的作用的随机对照试验。主要结局是用有效的工具测量疼痛强度。进行固定效应荟萃分析，结果表示为标准化平均差异（SMD）。使用Cochrane RoB工具评估偏倚风险，通过Egger’s漏斗图检查发表偏倚。结果：5项研究符合纳入标准；4例（n = 320）纳入meta分析。综合结果显示，与安慰剂相比，维生素D在短期内显著减轻了疼痛（SMD = -0.85; 95% CI: -1.07至-0.62），具有中等异质性（I2 = 61.4%），相当于普通疼痛量表上的~11分。没有研究报告中期或长期结果。研究质量各不相同，涉及分配、隐瞒和选择性结果报告。4项试验前瞻性登记。结论：补充维生素D可以减轻PDN患者的短期疼痛，但由于样本量小和方法学质量问题，证据有限。在临床实践中推荐常规维生素D检测或补充之前，需要更大规模、更严格设计、随访时间更长的随机对照试验。

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引用次数: 0

Diabetes and Obesity Modify the Effect of Alcohol Consumption on Carbohydrate-Deficient Transferrin 糖尿病和肥胖改变了饮酒对碳水化合物缺乏的转铁蛋白的影响。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-23 DOI: 10.1002/edm2.70112

Tomás González-Vidal, Óscar Lado-Baleato, Fátima de la Osa, Manuela Alonso-Sampedro, Carmen Fernández-Merino, Juan Sánchez-Castro, Francisco Gude, Arturo González-Quintela

Aims

Serum levels of carbohydrate-deficient transferrin (CDT, the sum of its asialylated and disialylated glycoforms) are a commercial marker of alcohol abuse. Our aim was to investigate the potential influence of metabolic factors on serum CDT levels and the predictive value of transferrin glycoforms for the development of type 2 diabetes in a general adult population.

Materials and Methods

We measured serum CDT levels by capillary electrophoresis in 1516 individuals (median age 52 years; 55.3% women) randomly selected from the general adult population of a municipality.

Results

Insulin resistance and the associated body mass index and diabetes modified the effect of alcohol consumption on CDT levels; i.e., CDT in heavy drinkers was lower in individuals with obesity than in lean counterparts and was also lower in people with diabetes than in normoglycaemic individuals. The relative abundance of transferrin glycoforms was not significantly associated with the development of type 2 diabetes after a mean follow-up of 7.4 years.

Conclusions

There is an interaction between alcohol consumption and factors associated with insulin resistance in relation to transferrin sialylation. The sensitivity of CDT for detecting heavy alcohol consumption might be limited in people with obesity or diabetes.

目的：血清碳水化合物缺乏转铁蛋白（CDT，其asialated和didialated糖型的总和）水平是酒精滥用的商业标志。我们的目的是研究代谢因素对血清CDT水平的潜在影响，以及转铁蛋白糖型对普通成年人2型糖尿病发展的预测价值。材料和方法：我们通过毛细管电泳检测了1516个个体（中位年龄52岁，55.3%的女性）的血清CDT水平，这些个体是随机从一个城市的普通成年人中选择的。结果：胰岛素抵抗及相关体重指数和糖尿病改变了饮酒对CDT水平的影响；也就是说，酗酒者中肥胖人群的CDT低于瘦人群，糖尿病患者的CDT也低于血糖正常的人群。在平均7.4年的随访后，转铁蛋白糖型的相对丰度与2型糖尿病的发展无显著相关。结论：饮酒与胰岛素抵抗相关因素与转铁蛋白唾液酰化之间存在相互作用。CDT检测大量饮酒的敏感性可能在肥胖或糖尿病患者中受到限制。

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引用次数: 0

Are Bifidobacterium Species Key Players in the Progression of Type 1 Diabetes? A Systematic Review 双歧杆菌在1型糖尿病的进展中起关键作用吗？系统评价。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-13 DOI: 10.1002/edm2.70120

Vanina Vergoz, Donna Jeong, Emma E. Hamilton-Williams

Background

Type 1 diabetes (T1D) frequently develops in childhood and is preceded by a non-symptomatic period of autoimmunity. Alterations in the gut microbiome are implicated in T1D pathogenesis. Bifidobacterium is a significant focus due to its positive health impacts, association with breastfeeding and presence in probiotics and infant milk-formulas. This systematic review aims to investigate Bifidobacterium's association with T1D across disease stages.

Methods

A comprehensive electronic search was conducted in MEDLINE, EMBASE and Web of Science, from 2011 to 2024. The search used a combination of medical subject headings and keywords related to Bifidobacterium. Studies included individuals at risk of T1D (pre-stage, stage 1 or 2 asymptomatic T1D) and with stage 3 symptomatic T1D while excluding T2D, clinical trials and animal studies.

Results

The search initially retrieved 1120 articles. Of these, 25 papers met the inclusion criteria, covering 4533 individuals (842 cases with or at-risk of T1D and 3691 healthy controls). The studies highlighted variability in Bifidobacterium abundance in T1D, with higher abundance found more often in at-risk asymptomatic individuals and lower abundance frequently found in those with established T1D.

Conclusion

These findings do not support loss of Bifidobacterium as a key factor in the early development of T1D. Further studies are needed to explore Bifidobacterium's role in T1D progression and management.

背景：1型糖尿病（T1D）经常发生在儿童时期，在此之前有一段无症状的自身免疫期。肠道微生物组的改变与T1D的发病机制有关。双歧杆菌由于其对健康的积极影响、与母乳喂养的关联以及益生菌和婴儿配方奶粉中的存在而成为一个重要的焦点。本系统综述旨在探讨双歧杆菌与T1D在疾病分期的关系。方法：对2011 - 2024年MEDLINE、EMBASE和Web of Science进行全面的电子检索。搜索使用了与双歧杆菌相关的医学主题标题和关键词的组合。研究包括有T1D风险的个体（前期、1期或2期无症状T1D）和3期有症状的T1D，但不包括T2D、临床试验和动物研究。结果：搜索最初检索到1120篇文章。其中，25篇论文符合纳入标准，涵盖4533人（842例T1D患者或高危患者，3691例健康对照）。这些研究强调了双歧杆菌在T1D中丰度的可变性，在有风险的无症状个体中发现的丰度较高，而在已确诊的T1D个体中发现的丰度较低。结论：这些发现不支持双歧杆菌缺失是T1D早期发展的关键因素。需要进一步研究双歧杆菌在T1D进展和管理中的作用。

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引用次数: 0

Remnant Cholesterol and Cardiovascular Risk in Adults With Type 1 Diabetes: A Nested Case–Control Study 1型糖尿病成人残留胆固醇与心血管风险：一项巢式病例对照研究

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-08 DOI: 10.1002/edm2.70114

Fernando Sebastian-Valles, Iñigo Hernando-Alday, Luis Eduardo Lander Lobariñas, Maria Luisa Palacios Berraquero, Jon Garai-Hierro, Gisela Liz Roman-Gomez, Álvaro Montes Muñiz, Victor Navas-Moreno, Purificación de Martinez Icaya, Juan José Raposo-López, Miguel Antonio Sampedro-Nuñez, Carmen González-Ávila, Jose Alfonso Arranz-Martín, Mónica Marazuela

Background

Despite advancements in therapeutic strategies, adults with type 1 diabetes (T1D) remain at high risk of cardiovascular disease (CVD). Traditional lipid parameters may not fully account for this residual risk. Remnant cholesterol—found in triglyceride-rich lipoproteins such as VLDL and IDL—has emerged as a potential contributor to atherogenesis but has not been extensively studied in T1D.

Methods

We conducted a nested case–control study within a multicentre Spanish cohort of 2187 adults with T1D. A total of 88 cases with a first CVD event (2010–2024) were matched 1:1 to controls by age, sex, diabetes duration, HbA1c, smoking, hypertension and retinopathy. Remnant cholesterol was calculated as total cholesterol minus HDL-C and LDL-C. Multivariable conditional logistic regression was used to assess associations with CVD. A stratified analysis by LDL-C quartiles was also performed to explore potential effect modification.

Results

The mean age of participants was 59.9 ± 12.1 years, 34.7% were female, the median duration of diabetes was 27.9 ± 13.3 years and mean HbA1c was 7.9%±1.3%. Remnant cholesterol levels in the highest quartile (> 28 mg/dL) were independently associated with increased risk of CVD (OR = 4.50; 95% CI: 1.34–15.08; p = 0.015). This association was evident only among individuals with LDL-C ≥ 100 mg/dL, while no significant relationship was observed in those with LDL-C < 100 mg/dL. A linear trend across LDL-C strata further supported a dose–response relationship. HDL-C < 45 mg/dL and triglycerides in the highest quartile were also associated with increased CVD risk. Notably, most participants did not achieve LDL-C targets and 41.4% were untreated.

Conclusions

Elevated remnant cholesterol is an independent predictor of cardiovascular disease in adults with T1D, particularly in those with suboptimally controlled LDL cholesterol. These findings highlight the importance of achieving LDL-C treatment goals and considering remnant cholesterol in cardiovascular risk assessment, supporting the need for targeted lipid-lowering strategies in T1D.

背景：尽管治疗策略有所进步，但成人1型糖尿病（T1D）仍处于心血管疾病（CVD）的高风险。传统的脂质参数可能不能完全解释这种剩余风险。残余胆固醇——在富含甘油三酯的脂蛋白如VLDL和idl中发现——已成为动脉粥样硬化的潜在因素，但尚未在T1D中进行广泛研究。方法：我们在西班牙多中心2187例T1D成人队列中进行了巢式病例对照研究。共有88例首次心血管疾病事件（2010-2024年）与对照组按年龄、性别、糖尿病病程、HbA1c、吸烟、高血压和视网膜病变进行1:1匹配。残余胆固醇计算为总胆固醇减去HDL-C和LDL-C。多变量条件逻辑回归用于评估与心血管疾病的关联。LDL-C四分位数的分层分析也探讨了潜在的影响修正。结果：参与者的平均年龄为59.9±12.1岁，女性34.7%，糖尿病的中位病程为27.9±13.3年，平均HbA1c为7.9%±1.3%。最高四分位数的残余胆固醇水平（> 28 mg/dL）与CVD风险增加独立相关（OR = 4.50; 95% CI: 1.34-15.08; p = 0.015）。这种关联仅在LDL-C≥100 mg/dL的个体中明显，而在LDL-C < 100 mg/dL的个体中没有观察到显著的关系。LDL-C地层的线性趋势进一步支持了剂量-反应关系。HDL-C < 45 mg/dL和最高四分位数的甘油三酯也与心血管疾病风险增加有关。值得注意的是，大多数参与者没有达到LDL-C目标，41.4%的参与者未经治疗。结论：残余胆固醇升高是成年T1D患者心血管疾病的独立预测因子，特别是那些LDL胆固醇控制不佳的患者。这些发现强调了实现LDL-C治疗目标和在心血管风险评估中考虑残余胆固醇的重要性，支持了T1D有针对性的降脂策略的必要性。

{"title":"Remnant Cholesterol and Cardiovascular Risk in Adults With Type 1 Diabetes: A Nested Case–Control Study","authors":"Fernando Sebastian-Valles, Iñigo Hernando-Alday, Luis Eduardo Lander Lobariñas, Maria Luisa Palacios Berraquero, Jon Garai-Hierro, Gisela Liz Roman-Gomez, Álvaro Montes Muñiz, Victor Navas-Moreno, Purificación de Martinez Icaya, Juan José Raposo-López, Miguel Antonio Sampedro-Nuñez, Carmen González-Ávila, Jose Alfonso Arranz-Martín, Mónica Marazuela","doi":"10.1002/edm2.70114","DOIUrl":"10.1002/edm2.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite advancements in therapeutic strategies, adults with type 1 diabetes (T1D) remain at high risk of cardiovascular disease (CVD). Traditional lipid parameters may not fully account for this residual risk. Remnant cholesterol—found in triglyceride-rich lipoproteins such as VLDL and IDL—has emerged as a potential contributor to atherogenesis but has not been extensively studied in T1D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a nested case–control study within a multicentre Spanish cohort of 2187 adults with T1D. A total of 88 cases with a first CVD event (2010–2024) were matched 1:1 to controls by age, sex, diabetes duration, HbA1c, smoking, hypertension and retinopathy. Remnant cholesterol was calculated as total cholesterol minus HDL-C and LDL-C. Multivariable conditional logistic regression was used to assess associations with CVD. A stratified analysis by LDL-C quartiles was also performed to explore potential effect modification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of participants was 59.9 ± 12.1 years, 34.7% were female, the median duration of diabetes was 27.9 ± 13.3 years and mean HbA1c was 7.9%±1.3%. Remnant cholesterol levels in the highest quartile (> 28 mg/dL) were independently associated with increased risk of CVD (OR = 4.50; 95% CI: 1.34–15.08; <i>p</i> = 0.015). This association was evident only among individuals with LDL-C ≥ 100 mg/dL, while no significant relationship was observed in those with LDL-C < 100 mg/dL. A linear trend across LDL-C strata further supported a dose–response relationship. HDL-C < 45 mg/dL and triglycerides in the highest quartile were also associated with increased CVD risk. Notably, most participants did not achieve LDL-C targets and 41.4% were untreated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Elevated remnant cholesterol is an independent predictor of cardiovascular disease in adults with T1D, particularly in those with suboptimally controlled LDL cholesterol. These findings highlight the importance of achieving LDL-C treatment goals and considering remnant cholesterol in cardiovascular risk assessment, supporting the need for targeted lipid-lowering strategies in T1D.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early Versus Late Diagnosis of Youth-Onset Type 2 Diabetes 青少年2型糖尿病的早期与晚期诊断。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-03 DOI: 10.1002/edm2.70116

Nisha Krishnan, Nancy A. Crimmins, Debi Swertfeger, Lisa Schaaf, Amy S. Shah

Objective

To determine if earlier age of diabetes onset (< 15 years of age) is associated with a worse metabolic phenotype compared to diabetes diagnosed at a later age (≥ 15 years of age).

Methods

Retrospective cross-sectional study of our clinical cohort was performed at a tertiary clinic between 2018 and 2023. Diabetes presentation (diabetic ketoacidosis, C-peptide levels, ketonuria), metabolic phenotype (body mass index (BMI) z-score, hypertension, dyslipidemia, elevated liver enzymes, and haemoglobin A1c) were compared between youth diagnosed with type 2 diabetes who were < 15 years of age and those ≥ 15 years of age. A p value of < 0.05 was considered significant.

Results

We studied n = 336 youth. Mean age was 14.5 years at type 2 diabetes diagnosis, n = 198 were < 15 years and n = 138 were ≥ 15 years old. Youth diagnosed at < 15 years versus ≥ 15 years old had a lower systolic and diastolic blood pressure (121.0 ± 12.0 vs. 125.0 ± 12.3 mmHg, p = 0.004 and 72.0 ± 9.8 vs. 74.9 ± 11.1 mmHg, p = 0.013 respectively), and higher HDL cholesterol (38.3 ± 11.7 vs. 35.7 ± 8.7 mg/dL, p = 0.049). There were no differences in the frequency of diabetic ketoacidosis, urine ketones at presentation, C-peptide concentrations, haemoglobin A1c, liver enzymes, total or LDL cholesterol, or BMI z-scores by age group.

Conclusions

A worse metabolic profile was not observed in youth diagnosed at a younger age. In fact, youth who were at an older age at diabetes diagnosis tended to have higher blood pressure and lower HDL-C. Establishing the risk factors for why some youth develop type 2 diabetes at earlier ages is needed.

目的：确定糖尿病发病年龄是否更早(方法：回顾性横断面研究我们的临床队列在2018年至2023年在三级诊所进行。比较2型糖尿病青年患者的糖尿病表现（糖尿病酮症酸中毒、c肽水平、酮症尿）、代谢表型（体重指数（BMI） z-score、高血压、血脂异常、肝酶升高和血红蛋白A1c），结果：我们研究了n = 336名青年。2型糖尿病诊断时的平均年龄为14.5岁，n = 198例。结论：在较年轻诊断的青少年中没有观察到较差的代谢谱。事实上，被诊断为糖尿病的年龄越大的年轻人血压越高，HDL-C含量越低。需要确定为什么一些年轻人在较早年龄患上2型糖尿病的风险因素。

{"title":"Early Versus Late Diagnosis of Youth-Onset Type 2 Diabetes","authors":"Nisha Krishnan, Nancy A. Crimmins, Debi Swertfeger, Lisa Schaaf, Amy S. Shah","doi":"10.1002/edm2.70116","DOIUrl":"10.1002/edm2.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine if earlier age of diabetes onset (< 15 years of age) is associated with a worse metabolic phenotype compared to diabetes diagnosed at a later age (≥ 15 years of age).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cross-sectional study of our clinical cohort was performed at a tertiary clinic between 2018 and 2023. Diabetes presentation (diabetic ketoacidosis, C-peptide levels, ketonuria), metabolic phenotype (body mass index (BMI) <i>z</i>-score, hypertension, dyslipidemia, elevated liver enzymes, and haemoglobin A1c) were compared between youth diagnosed with type 2 diabetes who were < 15 years of age and those ≥ 15 years of age. A <i>p</i> value of < 0.05 was considered significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We studied <i>n</i> = 336 youth. Mean age was 14.5 years at type 2 diabetes diagnosis, <i>n</i> = 198 were < 15 years and <i>n</i> = 138 were ≥ 15 years old. Youth diagnosed at < 15 years versus ≥ 15 years old had a lower systolic and diastolic blood pressure (121.0 ± 12.0 vs. 125.0 ± 12.3 mmHg, <i>p</i> = 0.004 and 72.0 ± 9.8 vs. 74.9 ± 11.1 mmHg, <i>p</i> = 0.013 respectively), and higher HDL cholesterol (38.3 ± 11.7 vs. 35.7 ± 8.7 mg/dL, <i>p</i> = 0.049). There were no differences in the frequency of diabetic ketoacidosis, urine ketones at presentation, C-peptide concentrations, haemoglobin A1c, liver enzymes, total or LDL cholesterol, or BMI <i>z</i>-scores by age group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A worse metabolic profile was not observed in youth diagnosed at a younger age. In fact, youth who were at an older age at diabetes diagnosis tended to have higher blood pressure and lower HDL-C. Establishing the risk factors for why some youth develop type 2 diabetes at earlier ages is needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association Between Serum Syndecan 1 Levels and Metabolic Syndrome Parameters: A Comparative Cross-Sectional Study 血清Syndecan 1水平与代谢综合征参数之间的关系：一项比较横断面研究

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-02 DOI: 10.1002/edm2.70108

Shima Tavalaie, Saeed Darroudi, Niloofar Shabani, Artemis AzadAra, Ali Mottaghi-Moghaddam, Mohammad Kalate Rahmani, Maryam Mohammadi-Bajgiran, Gordon A. Ferns, Maryam Saberi-Karimian, Majid Ghayour-Mobarhan

Introduction

Previous studies have linked Syndecans (SDCs) to hypertension (HTN), BMI and the prevalence of coronary artery disease (CAD). The relationship between SDCs and metabolic syndrome (MetS) has not been explored. This study aimed to investigate the association between serum SDC1 level and MetS.

Methods

This was a comparative cross-sectional study conducted on the subjects from phase II of the MASHAD study. A total of 81 subjects were divided into three groups: (1) healthy controls (N = 26), (2) subjects with MetS and hypertension with serum ALT < 43 U/L (MetS+ HTN+ ALT–), (N = 29), and (3) subjects with MetS and hypertension with serum ALT ≥ 43 U/L (MetS+ HTN+ ALT+), (N = 26). Serum SDC1 levels were measured using a commercial ELISA kit. Data were analysed using SPSS version 26 and R version 4.0.5 software.

Results

The analysis showed that mean serum SDC1 levels did not significantly differ between healthy and MetS+ groups overall. Among MetS+ subjects, males had significantly higher SDC1 levels than females (17.57 ± 8.48 vs. 12.85 ± 5.59 ng/mL, p = 0.018). In the MetS+ HTN+ ALT+ group, males also had higher SDC1 levels compared to females (20.19 ± 10.56 vs. 11.82 ± 5.09 ng/mL, p = 0.020), while no significant differences were observed across the MetS groups overall (p = 0.474). Additionally, in both the total study sample and the MetS+ HTN+ ALT+ group, SDC1 levels were positively correlated with diastolic blood pressure (DBP) (r = 0.256, p = 0.021; r = 0.463, p = 0.017, respectively), with no significant associations found with other metabolic parameters.

Conclusions

These findings suggest that SDC1 levels are higher in males with MetS, particularly those with hypertension and elevated ALT, and are positively associated with DBP in both the total study sample and the MetS+ HTN+ ALT+ group. There were no significant associations with other metabolic parameters. This indicates that SDC1 may serve as a gender-specific biomarker for vascular risk in MetS, potentially aiding clinicians in identifying high-risk MetS subjects.

先前的研究已将Syndecans （sdc）与高血压（HTN）、BMI和冠状动脉疾病（CAD）患病率联系起来。sdc与代谢综合征（MetS）之间的关系尚未探讨。本研究旨在探讨血清SDC1水平与MetS之间的关系。方法：对MASHAD二期研究的受试者进行比较横断面研究。81例受试者分为3组：(1)健康对照组（N = 26），(2)血清ALT+ HTN+ ALT - 43 U/L的met伴高血压患者（N = 29），(3)血清ALT≥43 U/L的met伴高血压患者（MetS+ HTN+ ALT+）（N = 26）。使用商用ELISA试剂盒检测血清SDC1水平。数据分析采用SPSS version 26和R version 4.0.5软件。结果分析显示，健康组和met +组之间的平均血清SDC1水平总体上没有显著差异。在met +受试者中，男性的SDC1水平显著高于女性（17.57±8.48 vs. 12.85±5.59 ng/mL, p = 0.018）。在MetS+ HTN+ ALT+组中，男性的SDC1水平也高于女性（20.19±10.56 vs. 11.82±5.09 ng/mL, p = 0.020），而MetS组之间总体上没有显著差异（p = 0.474）。此外，在总研究样本和MetS+ HTN+ ALT+组中，SDC1水平与舒张压（DBP）呈正相关（r = 0.256, p = 0.021; r = 0.463, p = 0.017），与其他代谢参数无显著相关性。这些研究结果表明，SDC1水平在met男性患者中较高，特别是高血压和ALT升高的男性患者，并且在总研究样本和MetS+ HTN+ ALT+组中与DBP呈正相关。与其他代谢参数无显著相关性。这表明SDC1可以作为MetS血管风险的性别特异性生物标志物，潜在地帮助临床医生识别高风险的MetS受试者。

{"title":"Association Between Serum Syndecan 1 Levels and Metabolic Syndrome Parameters: A Comparative Cross-Sectional Study","authors":"Shima Tavalaie, Saeed Darroudi, Niloofar Shabani, Artemis AzadAra, Ali Mottaghi-Moghaddam, Mohammad Kalate Rahmani, Maryam Mohammadi-Bajgiran, Gordon A. Ferns, Maryam Saberi-Karimian, Majid Ghayour-Mobarhan","doi":"10.1002/edm2.70108","DOIUrl":"https://doi.org/10.1002/edm2.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Previous studies have linked Syndecans (SDCs) to hypertension (HTN), BMI and the prevalence of coronary artery disease (CAD). The relationship between SDCs and metabolic syndrome (MetS) has not been explored. This study aimed to investigate the association between serum SDC1 level and MetS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a comparative cross-sectional study conducted on the subjects from phase II of the MASHAD study. A total of 81 subjects were divided into three groups: (1) healthy controls (<i>N</i> = 26), (2) subjects with MetS and hypertension with serum ALT < 43 U/L (MetS+ HTN+ ALT–), (<i>N</i> = 29), and (3) subjects with MetS and hypertension with serum ALT ≥ 43 U/L (MetS+ HTN+ ALT+), (<i>N</i> = 26). Serum SDC1 levels were measured using a commercial ELISA kit. Data were analysed using SPSS version 26 and R version 4.0.5 software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis showed that mean serum SDC1 levels did not significantly differ between healthy and MetS+ groups overall. Among MetS+ subjects, males had significantly higher SDC1 levels than females (17.57 ± 8.48 vs. 12.85 ± 5.59 ng/mL, <i>p</i> = 0.018). In the MetS+ HTN+ ALT+ group, males also had higher SDC1 levels compared to females (20.19 ± 10.56 vs. 11.82 ± 5.09 ng/mL, <i>p</i> = 0.020), while no significant differences were observed across the MetS groups overall (<i>p</i> = 0.474). Additionally, in both the total study sample and the MetS+ HTN+ ALT+ group, SDC1 levels were positively correlated with diastolic blood pressure (DBP) (<i>r</i> = 0.256, <i>p</i> = 0.021; <i>r</i> = 0.463, <i>p</i> = 0.017, respectively), with no significant associations found with other metabolic parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that SDC1 levels are higher in males with MetS, particularly those with hypertension and elevated ALT, and are positively associated with DBP in both the total study sample and the MetS+ HTN+ ALT+ group. There were no significant associations with other metabolic parameters. This indicates that SDC1 may serve as a gender-specific biomarker for vascular risk in MetS, potentially aiding clinicians in identifying high-risk MetS subjects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0